Until physicians and scientists find a way to produce permanent and well-functioning hearts, lungs, livers, kidneys, pancreases, intestines, corneas and the like, people whose organs or vital tissues have deteriorated seriously will need to undergo transplants.

The transplantation of solid organs – which began with the first successful kidney transplant in Boston in 1954 – is one of the most dramatic and amazing medical advances in the past 60 years. Although the first such operation was regarded as a desperate clinical experiment, organ transplantation today is routine in hospitals around the world, regarded as a cost-effective treatment and the best way to extend the lives of hundreds of thousands of patients around the world.

Experimental transplants were performed in animals and then between identical twins, in which the recipient’s body would not reject the organ from his or her sibling. The first simultaneous human kidney/pancreas transplant was performed in 1966, followed a year later by the first successful liver transplant and the first heart transplant.

In the early 1980s, when drugs and techniques to prevent and treat rejection of the foreign tissue by the recipient’s immune system were applied, lung and intestinal organ transplant procedures were performed, leading the way to such operations becoming commonplace. Cyclosporine, the first of a number of drugs that effectively treat organ rejection by suppressing the human immune system, was introduced in 1983.

Since then, there has always been a shortfall in numbers of suitable donor organs available for transplant. As the “time window” for using donor organs is limited, current research is aimed at techniques to improve the preservation of organ organs.

Organ donation had a slow start in Israel, as ultra-Orthodox and modern Orthodox Jewish and Muslim families were reluctant to agree to donate their loved ones’ organs out of the mistaken belief that, under religious law, a body had to be buried whole even if parts would save other lives.

Even today, many ultra-Orthodox rabbis and congregants are unwilling to consent; they insist that a Jewish donor’s heart must have stopped beating, even if the patient’s lower brain was dead, before organs could be taken. But donor organs have the best chance of being effective if the brain-dead patient’s heart continued beating artificially before the organ was removed.

Most of the Israeli public has come to realize that it is an important positive commandment to donate organs for transplant, either from the deceased or kidneys or liver lobes from living donors.

In 1974, Dvora Ben-Dror established ADI, a voluntary organization to encourage donation of organs, after her son, Ehud, died for lack of a kidney. Just a week ago, Dvora died at the age of 93 and was much-praised for her efforts, which eventually saved the lives of thousands of Israelis.

ADI was made part of the Health Ministry’s National Transplant Center, a neutral, national organization responsible for managing and coordinating the country’s organ donation and transplant system. It is chaired by Rambam Medical Center director-general Prof. Rafael Beyar and headed by Dr. Tamar Ashkenazi.

A former hospital nurse and a bereavement counselor, Ashkenazi grew up on the small kibbutz. She learned as a fourth grader that her cousin was killed in a Jerusalem battle during the Six Day War. She also witnessed from age 17 the funerals of kibbutz members who fell in the Yom Kippur War. Her fiancé Adi died of kidney failure in her arms (a kidney transplant failed) when she was just 22. She lost her grandparents, father and mother to disease. As the Health Ministry official in charge of encouraging and coordinating organ donations for more than two decades, Ashkenazi has accompanied hundreds of people facing their loved ones’ passing while refusing to lose hope.

Signing a green, white and red ADI donor card testifies to the desire of the card-holder to donate his organs after his death to save the lives of patients awaiting transplants. Organ donation is an unquantifiable gift, given to a person in need, out of a genuine desire to help. Altruism is the primary motivation, which people cite when they are asked why they are prepared to be posthumous organ donors or when family members respond to requests to donate organs of deceased family members.

The desire to help others, for no immediate or personal gain, is the main motivation for most of the people who express their willingness to donate their organs posthumously and among families that donate organs from their loved ones.

The decision of family members, in their moments of sorrow and despair, to donate their loved ones’ organs, is a noble deed, as it may lead to the extension of life or to a drastic improvement of the quality of the life of the person in need of an organ donation.

People may agree to donate not only kidneys, lungs, liver (and liver lobes), hearts and pancreases in Israel, but also various tissues such as corneas, bones, tendons, joints, skin and heart valves.

Israel Transplant has just reported that 2018 saw record of families – 64% – willing to donor their brain-loved one’s organs for transplant. In addition, 100% of families whose relative’s heart had stopped beating were willing to give organs.

A total of 592 organs of all types were donated by living persons and families of the deceased in 2018; this was the highest number in Israel Transplant history. These include 26 heart transplants, a 44% increase compared to the previous year. There were also 100 livers taken from deceased donors and transplant. Kidney transplants from live donors rose to 231, a 4% increase over the 2017 figure.

Today, there are a total of 944,000 bearers of ADI cards, a 39,000 increase over the 2017 figure. Nevertheless, there is more work to do, as at the end of 2018, there were 1,123 Israelis waiting in the line for an organ transplant compared to 1,138 at the beginning of 2018.

This year, the National Transplant Center marks the 40th anniversary of the ADI card and has embarked on a variety of media and social activities to raise awareness of organ donations.

Beyar said that in 2019, Israel Transplants plans to promote cooperation with various countries relation to sharing organs not suitable for transplanting into Israeli patients. It will also use computer software to find matches/cross-matches between couples from other countries that did not find a matched donor.

Ashkenazi added that “a new record in the number of organs donations and transplants, which is evidence of an increase in public awareness and willingness. Our slogan ‘All of Israel Sign for Each Other’ means a great deal of mutual responsibility for saving lives. I would like to thank the families of organ and tissue donors, as well as to convey my appreciation to the transplant coordination teams and hospital transplant coordinators and to the doctors and nurses who work day and night to save lives.”